Identifying gaps in the practices of rural health extension workers in Ethiopia: a task analysis study.
Background: Health extension workers (HEWs) are the frontline health workers for Ethiopia's primary health care system. The Federal Ministry of Health is seeking to upgrade and increase the number of HEWs, particularly in remote areas, and address concerns about HEWs' pre-service education and pract...
| Publicado en: | BMC Health Services Research Vol. 17; pp. 1 - 10 |
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| Autores principales: | , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
BioMed Central
12/20/2017
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=126966113&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 126966113 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14726963 1CHS jtl: BMC Health Services Research issn: 14726963 maglogo: N pubinfo: dt: 12/20/2017 vid: 17 pid: 24147 pub: BioMed Central artinfo: ui: 126966113 126966113 NLM29262806 126966113 10.1186/s12913-017-2804-0 NLM29262806 126966113 ppf: 1 ppct: 9 formats: tig: atl: Identifying gaps in the practices of rural health extension workers in Ethiopia: a task analysis study. aug: au: Desta, Firew Ayalew Shifa, Girma Temam Dagoye, Damtew WoldeMariam Carr, Catherine Van Roosmalen, Jos Stekelenburg, Jelle Nedi, Assefa Bulcha Kols, Adrienne Young Mi Kim Kim, Young Mi affil: Jhpiego, Addis Ababa, Ethiopia sug: subj: Clinical Competence Standards Rural Health Community Health Workers Education Female Young Adult Adult Male Employee Orientation Cross Sectional Studies Ethiopia Funding Source Human Adult: 19-44 years Female Male ab: Background: Health extension workers (HEWs) are the frontline health workers for Ethiopia's primary health care system. The Federal Ministry of Health is seeking to upgrade and increase the number of HEWs, particularly in remote areas, and address concerns about HEWs' pre-service education and practices. The aim of this study was to identify gaps in HEWs' practices and recommend changes in their training and scope of practice.Methods: A cross-sectional descriptive task analysis was conducted to assess the work of rural HEWs who had been in practice for six months to five years. One hundred participants were invited from 100 health posts in five regions of Ethiopia. HEWs self-reported on 62 tasks on: frequency, criticality (importance), where the task was learned, and ability to perform the task. Descriptive statistics, including frequencies and percentages, were computed for each variable. Task combinations were examined to identify tasks performed infrequently or for which HEWs are inadequately prepared.Results: A total of 82 rural HEWs participated in the study. Nearly all HEWs rated every task as highly critical to individual and public health outcomes. On average, most HEWs (51.5%-57.4%) reported learning hygiene and environmental sanitation tasks, disease prevention and control tasks, family health tasks, and health education and communication tasks outside of their pre-service education, primarily through in-service and on-the-job training. Over half of HEWs reported performing certain critical tasks infrequently, including management of supplies, stocks and maintenance at the facility and management of the cold chain system. Almost all HEWs (95.7-97.2%) perceived themselves as competent and proficient in performing tasks in all program areas.Conclusion: HEWs were insufficiently prepared during pre-service education for all tasks that fall within their scope of practice. Many learned tasks through in-service or on-the-job training, and some tasks were not learned at all. Some tasks that are part of expected HEW practice were performed infrequently, potentially reducing the effectiveness of the Health Extension Program to provide preventive and basic curative health care services to communities. Findings should alert policy makers to the need to review HEWs' scope of practice, update pre-service education curricula and prioritize in-service training modules. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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